Laher Fatima, Salami Taibat, Hornschuh Stefanie, Makhale Lerato M, Khunwane Mamakiri, Andrasik Michele P, Gray Glenda E, Van Tieu Hong, Dietrich Janan J
Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Diepkloof, P.O. Box 114, Johannesburg, Soweto, 1864, South Africa.
School of Medicine, University of Texas, San Antonio, TX, USA.
BMC Public Health. 2020 Nov 7;20(1):1669. doi: 10.1186/s12889-020-09785-0.
Despite multiple available HIV prevention methods, the HIV epidemic continues to affect South Africa the most. We sought to understand willingness to use actual and hypothetical HIV prevention methods among participants enrolled in a preventative HIV vaccine efficacy trial in Soweto, South Africa.
We conducted a qualitative study with 38 self-reporting HIV-uninfected and consenting 18-35 year olds participating in the HVTN 702 vaccine efficacy trial in Soweto. Using a semi-structured interview guide, five focus group discussions (FGDs) were held, stratified by age, gender and sexual orientation. The FGDs were composed of: (i) 10 heterosexual women aged 18-24 years; (ii) 9 heterosexual and bisexual women aged 25-35 years; (iii & iv) heterosexual men aged 25-35 years with 7 in both groups; and (v) 5 men aged 18-35 years who have sex with men. FGDs were audio-recorded, transcribed verbatim, translated into English and analysed using thematic analysis.
We present five main themes: (i) long-lasting methods are preferable; (ii) condoms are well-known but not preferred for use; (iii) administration route of HIV prevention method is a consideration for the user; (iv) ideal HIV prevention methods should blend into the lifestyle of the user; and the perception that (v) visible prevention methods indicate sexual indiscretion.
The participants' candour about barriers to condom and daily oral pre-exposure prophylaxis (PrEP) use, and expressed preferences for long-lasting, discreet, lifestyle-friendly methods reveal a gap in the biomedical prevention market aiming to reduce sexually acquired HIV in South Africa. Product developers should consider long-acting injectable formulations, such as vaccines, passive antibodies and chemoprophylaxis, for HIV prevention technologies. Future innovations in HIV prevention products may need to address the desire for the method to blend easily into lifestyles, such as food-medication formulations.
尽管有多种可用的艾滋病病毒预防方法，但艾滋病病毒疫情仍对南非影响最为严重。我们试图了解参与南非索韦托一项预防性艾滋病病毒疫苗疗效试验的参与者对实际和假设的艾滋病病毒预防方法的使用意愿。
我们对38名自我报告未感染艾滋病病毒且年龄在18至35岁之间并同意参与索韦托HVTN 702疫苗疗效试验的参与者进行了定性研究。使用半结构化访谈指南，按年龄、性别和性取向分层进行了五次焦点小组讨论（FGD）。焦点小组讨论由以下人员组成：（i）10名年龄在18至24岁之间的异性恋女性；（ii）9名年龄在25至35岁之间的异性恋和双性恋女性；（iii和iv）每组各7名年龄在25至35岁之间的异性恋男性；以及（v）5名年龄在18至35岁之间的男男性行为者。焦点小组讨论进行了录音，逐字转录，翻译成英文，并使用主题分析法进行分析。
我们呈现了五个主要主题：（i）长效方法更可取；（ii）避孕套广为人知但不被首选使用；（iii）艾滋病病毒预防方法的给药途径是使用者考虑的因素；（iv）理想的艾滋病病毒预防方法应融入使用者的生活方式；以及（v）可见的预防方法表明性行为不检点的观念。
参与者对避孕套和每日口服暴露前预防（PrEP）使用障碍的坦诚，以及对长效、隐秘、适合生活方式方法的偏好，揭示了旨在减少南非性传播艾滋病病毒的生物医学预防市场存在的差距。产品开发者应考虑将长效注射制剂，如疫苗、被动抗体和化学预防，用于艾滋病病毒预防技术。未来艾滋病病毒预防产品的创新可能需要满足将方法轻松融入生活方式的需求，比如食品 - 药物制剂。
